| NPI | 1295876944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00041769) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE00010683) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2013-01-15 |